Facility Evaluation Report

Licensing Program Analyst (LPA) V. Maldonado made an unannounced complaint visit at the facility for the purpose of conducting the annual inspection, using the Care Compliance and Regulatory Enforcement (CARE) Tool to evaluate the facility. Upon arrival, LPA knocked on the door several times and called the facility telephone number. There was no answer. LPA phoned Licensee Aucione Eve directly and informed her of the visit. She stated she would come over right away and arrived shortly after with Leslie Eve to assist with the visit. The facility is licensed to serve adult clients, ages 18-59, and is approved for (4) ambulatory clients, only.

The facility is a single-story home, located in a residential area. The home consists of a living room, (2) client bedrooms, (1) isolation/COVID-19 room with bathroom, (1) client bathroom, a kitchen, dining room, attached garage, and shaded patio with seating in the back yard.

The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incident Medical and Dental, Disaster Preparedness, and Emergency Intervention.

During today's visit, LPA Maldonado obtained a copy of the client and staff roster, and conducted a tour of the physical plant with assistance of Licensee. The following was observed:

One central entry point for universal entry screening

Mitigation Plan and Infection Control Plan approved and in place

Sufficient PPE stored for 30-days and readily available for use, throughout the home and stored in the garage

Physical plant inside and outside is clean, sanitary and in good repair

All walkways and pathways observed to be free of obstruction/hazards